Dyslexia Diagnostic Checklist

HISTORY

Classroom Teacher:
Has the classroom teacher made accommodations and modified classroom instruction strategies?
What accommodations and modifications were made?

Family:
Does a history of oral or written language problems exist in the family? _____
Are there problems in the home? _____

School :
Did the child attend kindergarten? _____ First Grade ? _____ When did trouble with reading arise? _____
What help has he or she had? _________________________________________
Is the child chronically absent? _____

Compensatory Programs:
Has the child been placed in a remedial or compensatory program? _____
In what program was the child placed? _____

Hearing Test:
Can the child hear spoken language? _____ Can the child hear verbal instruction? _____
What is the score of the hearing screening? _____

Vision Test:
Can the child see print and letters on the blackboard? _____
What is the score of the vision screening? _____

Physical Examination:
Has the child been critically or chronically ill? _____ Is physical development normal? _____
Do physical problems exist causing aggravation, to the reading difficulties? _____

Neurological Screening:
Has the child had a brain insult, disease, or surgery aggravating to the reading problem? _____

Intelligence:
Does the child have intelligence to develop reading skills at the level of his or her peers? _____
What is the child's IQ? _____

Oral Language:
Is speech normal? _____ Are speech problems aggravating the reading problem? _____
Can the child understand classroom instruction? _____
Can he or she communicate effectively for his or her age? _____

WRITTEN LANGUAGE

Alphabet:
Can the child recite the alphabet correctly? _____
Write in sequence, forming letters correctly? _____

Reading Accuracy:
Can the child read at grade level and on a level with his or her mental age? _____
Does the child have above average IQ? _____ Has the child been given a reading placement test? _____
When was the test given? _____ What is the level of placement? _____

Reading Comprehension:
Does the child comprehend reading at grade level and at level of mental age? _____
Does the child have normal IQ? _____

Handwriting:
Is quality and rate of child’s handwriting at grade level? _____
Is the problem with handwriting caused by poor visual-motor coordination? _____

Spelling:
Are the child’s spelling skills at grade level? _____ Are child’s spelling skills above their IQ ability? _____

Written Expression:
Can the child communicate effectively for his or her age in writing?  _____

OTHER SYMBOL SYSTEMS

Arithmetic:
Are the child’s mathematics skills on grade level? _____ Are they higher than reading skills? _____

Attention Span:
Can the child pay attention well enough to make normal progress in the classroom? _____

Behavior Assessment:
Is the child’s behavior affecting or being affected by his or her academic achievement?  _____

TEAMS/TAAS

What were the results of the child’s TEAMS/TAAS Test? _____ Reading _____ Writing _____ Math _____

Parent Conference:
Have you conference with the child’s parents? _____ When was the conference? _____
Briefly summarize the conference:

Academic Progress Report:
What are the most recent grades the child has made on his or her academic progress report?
Reading _____ Spelling _____ Writing _____ Language _____ Math _____
Social Studies _____ Science _____ Music _____ Art _____ P.E. _____

Aptitude:
What do you consider to be this student’s strong points? ______________________________